Clarence Aaron Enos, LCMSW
Social Worker, Clinical in Gallup, NM. Individual provider (NPI-1).
NPI number1306279559
StatusActive
Last updated in NPPESApr 13, 2018
Details
- NPI
- 1306279559
- Entity type
- Individual (NPI-1)
- Name
- Clarence Aaron Enos
- Credential
- LCMSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 12, 2013
- Last updated
- Apr 13, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | X-10430 | NM | Yes |
| 104100000X | Social Worker | M-07770 | NM |
Practice location
216 W Maloney AveGallup, NM 87301-5214
Phone 505-870-1483
Mailing address
Po Box 3809Gallup, NM 87305-3809
Phone 505-863-3377
Other practice locations
211 W Mesa Ave Ste 4
Gallup, NM 87301-6392
Gallup, NM 87301-6392
Phone 505-879-3608
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